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Lessons from Africa

Professor Scott Murray, GP and St Columba’s Chair of Primary Palliative Care at the University of Edinburgh, shares some of his experiences from a recent trip to East Africa:

I am just back from amazing two weeks in East Africa. My son Andrew was taking on a series of epic challenges, which included running up Mt Kilimanjaro in a day (he took 7hrs 16 minutes from base camp), doing the same with Mt Kenya, and running over 50km every day for 18 days straight across East Africa.

My wife Mary and I helped with support, and like Andrew did a bit of running, and went up Mt Longonot (2786 metres) to raise money and awareness for the African Palliative Care Association. (Donations are extremely welcome.)

In addition to seeing some incredible sights (and getting a puncture next to a pride of lions), East Africa offered an opportunity to learn and share knowledge.

Andrew works as a Sports Medicine doctor and spent time learning from Olympic Champions, World Record holders and World Champions to unpick why Kenyans are so good at distance running- the village of Iten won more medals at the last Athletics World Championships than China and the UK combined. The universal opinion was it was not due to genetics, but due to a range of population factors (the Kenyan kids are more fit and fewer are overweight) and their top athletes’ sheer determination to do everything it takes to be a champion, maintaining a clear focus and involving the right people.

Our palliative care team in Edinburgh has a UK government grant to help train doctors and nurses in 12 African countries in palliative care, and funds from this run will help ensure there is morphine to be prescribed. The Kenya Palliative Care Association were exceptionally welcoming, and we visited two hospitals to encourage palliative care staff: at Chogoria where I used to work, (see photo of the team there) and in Eldoret near Iten, the village of champions.

Visiting with the Palliative Care service Chogoria HospitalFor palliative care to succeed in Africa much effort will be needed due to the lack of funds for equipment and medicines. But just as in running they have many resources to call on: neighbours and local communities supporting each-other, a willingness to face up to the inevitability of death and dying, and spiritual support from many church groups. Many people are still dying in pain in Africa, but many countries like Kenya and Uganda are achieving notable successes with visionaries introducing palliative care in nursing and medical training, and making morphine available.

We in “developed countries” can learn much from Africa about how neighbours and local communities and churches can support and help people at the end of life die with dignity among their family. We must help individuals and local communities cheer people on at the finishing line of their race. And in the meantime we can help by getting pain relief to people who are suffering unnecessarily by training local leaders to train local staff.

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